Provider Demographics
NPI:1528340387
Name:SCHWARTZ, MEGAN (PHARMD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:SCHWARTZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 NOANK RD
Mailing Address - Street 2:
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-2319
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:180 MAIN ST
Practice Address - Street 2:
Practice Address - City:DEEP RIVER
Practice Address - State:CT
Practice Address - Zip Code:06417-2039
Practice Address - Country:US
Practice Address - Phone:860-526-8052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-16
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0011811183500000X
SC12922183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist